Adenoid cystic carcinoma of the esophagus: report of two cases and review of the Chinese literature.

Guo XF, Mao T, Gu ZT, Fang WT, Chen WH, Shao JC - Diagn Pathol (2012)

Bottom Line:
Squamous cell carcinoma is the major pathology type of esophageal cancer in China, where adenocarcinoma is rare and adenoid cystic carcinoma (ACC) is more rare comparing to the western countries.We report the surgical and pathologic findings of two cases of primary ACC of the esophagus, and review of the Chinese literature of this tumor.The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1507582238843246.

Unlabelled: Squamous cell carcinoma is the major pathology type of esophageal cancer in China, where adenocarcinoma is rare and adenoid cystic carcinoma (ACC) is more rare comparing to the western countries. We report the surgical and pathologic findings of two cases of primary ACC of the esophagus, and review of the Chinese literature of this tumor.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1507582238843246.

Mentions:
A 70-year-old man was hospitalized with a 3-month history of progressive dysphagia. This patient’s occupation as a cook, he likes to eat hot, spicy foods, and no previous history of viral infection, there is no contact with any external toxic substances. However, this patient usually have reflux esophagitis. Barium esophagram revealed a protruding lesion of 5cm in length in the middle third of the esophagus (Figure 1A). Computed tomography of the chest showed a remarkable thickening of the mid-thoracic esophagus (Figure 1B). Esophagoscopy showed a cauliflower-like polypoid lesion (Figure 1C). A biopsy specimen suggested poorly differentiated squamous cell carcinoma, and a subtotal esophagectomy was performed (Ivor- Lewis). There was no evidence of direct invasion to the neighboring structures, lymphatic spread, or organ metastasis. The resected specimen consisted of 12 cm of the esophagus and 6cm of the upper portion of the stomach. A protuberant lobulated tumor, 6 × 3.8 × 2.5 cm in size (Figure 1D). Microscopic examination demonstrated an infiltrative malignant neoplasm composed of basaloid cells, exhibiting indistinct cell borders, scant amphophilic cytoplasm and enlarged hyperchromatic nuclei (Figure 1E). The tumor invaded the submucosa, but it had not metastasized to the lymph nodes (pT1bN0M0). Immunohistochemical studies revealed that tumor cells were stained immunohistochemically for CK, VIM, and Calponin protein. The patient was discharged from hospital 14 days after his operation, and no signs of recurrence have been detected in 5 months of follow up.

Mentions:
A 70-year-old man was hospitalized with a 3-month history of progressive dysphagia. This patient’s occupation as a cook, he likes to eat hot, spicy foods, and no previous history of viral infection, there is no contact with any external toxic substances. However, this patient usually have reflux esophagitis. Barium esophagram revealed a protruding lesion of 5cm in length in the middle third of the esophagus (Figure 1A). Computed tomography of the chest showed a remarkable thickening of the mid-thoracic esophagus (Figure 1B). Esophagoscopy showed a cauliflower-like polypoid lesion (Figure 1C). A biopsy specimen suggested poorly differentiated squamous cell carcinoma, and a subtotal esophagectomy was performed (Ivor- Lewis). There was no evidence of direct invasion to the neighboring structures, lymphatic spread, or organ metastasis. The resected specimen consisted of 12 cm of the esophagus and 6cm of the upper portion of the stomach. A protuberant lobulated tumor, 6 × 3.8 × 2.5 cm in size (Figure 1D). Microscopic examination demonstrated an infiltrative malignant neoplasm composed of basaloid cells, exhibiting indistinct cell borders, scant amphophilic cytoplasm and enlarged hyperchromatic nuclei (Figure 1E). The tumor invaded the submucosa, but it had not metastasized to the lymph nodes (pT1bN0M0). Immunohistochemical studies revealed that tumor cells were stained immunohistochemically for CK, VIM, and Calponin protein. The patient was discharged from hospital 14 days after his operation, and no signs of recurrence have been detected in 5 months of follow up.

Bottom Line:
Squamous cell carcinoma is the major pathology type of esophageal cancer in China, where adenocarcinoma is rare and adenoid cystic carcinoma (ACC) is more rare comparing to the western countries.We report the surgical and pathologic findings of two cases of primary ACC of the esophagus, and review of the Chinese literature of this tumor.The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1507582238843246.

Unlabelled: Squamous cell carcinoma is the major pathology type of esophageal cancer in China, where adenocarcinoma is rare and adenoid cystic carcinoma (ACC) is more rare comparing to the western countries. We report the surgical and pathologic findings of two cases of primary ACC of the esophagus, and review of the Chinese literature of this tumor.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1507582238843246.